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Tiotropium taken as mist for COPD may increase risk of death
Medpage Today
An inhaled mist formulation of tiotropium, used to treat chronic obstructive pulmonary disease (COPD), is associated with an increased risk of death compared with placebo, researchers reported.
Tiotropium mist is not approved for use in the United States, though the powder form is widely prescribed under the brand name Spiriva.
In a meta-analysis of five placebo-controlled trials, the mist formulation of the drug was associated with a 52% increase in the mortality rate, according to Sonal Singh, MBBS, of Johns Hopkins University School of Medicine, and colleagues.
The increase varied depending on the dose used, 5 µg or 10 µg a day, Singh and colleagues reported in the British Medical Journal. A linked editorial says the evidence suggests that using a tiotropium inhaler with a powder formulation is a safer bet than using a tiotropium mist inhaler, pending the results of a head to head trial.
Tiotropium, a long-acting anticholinergic drug, is widely used to treat COPD and can be delivered either in a powder form or in an inhaled mist. Although the mist formulation is not approved in the U.S., it is licensed in 55 countries.
